JPEN J Parenter Enteral Nutr. 2021 Aug 12. doi: 10.1002/jpen.2251. Online ahead of print.
ABSTRACT
BACKGROUND & AIM: The Patient-Generated Subjective Global Assessment short form (PG-SGA SF) is a standardized tool for assessing nutritional risk in patients with cancer. The aim of this study was to propose and validate a cutoff point for the PG-SGA SF score related to the prognosis of patients with incurable cancer in exclusive palliative care.
METHODS: This data analysis is from a prospective cohort study carried out patients with incurable cancer at the National Cancer Institute in Brazil. A total sample (n = 2,144) was randomly divided into groups: (A) training (n = 1,072), to determine the most accurate PG-SGA SF cutoff; and (B) validation (n = 1,072), to test the predictive accuracy of this cutoff point. The receiver operating characteristic (ROC) curve was plotted to determine the best cutoff point of the PG-SGA SF related to death. Concordance statistics (c-statistic) were used to test the predictive accuracy of the models. Kaplan Meier’s curve and the Cox hazard model were used to verify a prognostic value of the cutoff point.
RESULTS: PG-SGA SF score ≥15 was found to be the best cutoff based on 90-day mortality with good accuracy discrimination (C-statistic ≥0.74). Patients whose PG-SGA SF score ≥15 had a shorter survival of 32 days (interquartile range, IQR: 12-75) vs. 83 days (IQR: 31-90), p-value <0.001, and higher risk of death (hazard ratio: 2.20; 95% CI: 1.64-2.95).
CONCLUSIONS: The proposed PG-SGA SF cutoff score is valid and alongside its usefulness in nutritional triage, it could provide prognostic value for patients with incurable cancer.
CLINICAL RELEVANCY STATEMENT: Patients with incurable cancer in palliative care are often undernourished, and have shortened overall survival. As nutritional status in constantly evaluated in these patients, tools commonly used could also have prognostic value, broadening their applicability. PG-SGA is a validated tool for patients with cancer, and alongside its usefulness in screening for nutritional risk, it could provide prognostic value, guiding interventions better suited to each patient. This article is protected by copyright. All rights reserved.
PMID:34383972 | DOI:10.1002/jpen.2251
